Comorbid autoimmune diseases and burden of diabetes-related complications in patients with type 1 diabetes from a Mediterranean area

Giménez-Pérez, Gabriel; Vlacho, Bogdan; Elena, Navas; Mata-Cases, Manel; Real, Jordi; Xavier, Cos; Franch‐Nadal, Josep; Mauricio, Daniel

doi:10.1016/j.diabres.2022.110031

Cited by 5 publications

(13 citation statements)

References 39 publications

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“…Differences in the prevalence of AIDs in patients with T1D have been described worldwide and have been related to methodological, demographic and ethnic factors [ 7 – 10 ]. In general, most of these studies have shown a prevalence ranging from 18.3 to 27% being AITD the most common, similar to our findings.…”

Section: Discussionmentioning

confidence: 99%

“…It should be noted that celiac disease is more frequently found in children with a younger age at diagnosis [ 5 ], while thyroid autoimmunity is more frequently found among children older than ten years [ 6 ]. The presence of these AIDs can negatively impact health, quality of life and cognitive function increasing the burden and the daily challenge to deal with T1D [ 5 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence and types of combinations of AIDs with T1D vary widely depending on demographic variables such as gender, age, ethnicity, and diabetes duration [ 7 – 10 ]. In Finland, the country with the highest incidence of T1D, one in five patients with T1D has another associated AID [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Another point that deserves attention is the possible relationship between different types of AIDs and diabetes-related chronic complications (DRCC). Few studies have addressed this subject [ 7 , 9 ] and have used database from Catalonia in Spain [ 7 ] and from the USA [ 9 ]. Both studies have shown an association between the presence of AIDs with DRCC.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of autoimmune diseases in an admixed population of patients with type 1 diabetes: a multicenter study in Brazil

Gomes,

Braga,

Drummond

et al. 2024

Diabetol Metab Syndr

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Background/objectives The primary aim of this study was to evaluate the prevalence of autoimmune diseases (AIDs) and its associated factors in an admixed Brazilian population of patients with type 1 diabetes (T1D). The secondary one was to determine the relationship between AIDs and the occurrence of diabetes-related chronic complications (DRCC). Methods This cross-sectional, nationwide survey was conducted in 13 public clinics in 11 Brazilian cities. Overall, 1,760 patients were included; 967 females (55.9%), 932 (54%) Caucasians, aged 29.9 ± 11.9 years, age at diagnosis 14.8 ± 8.9 years, diabetes duration 15.5 ± 9.3 years and 12.2 ± 3.8 years of school attendance. AIDs were retrieved from medical records or self-report and stratified as follows: absence of AIDs, only autoimmune thyroid disease (AITD), and other AIDs including the combination with AITD (hyper or hypothyroidism). Results The prevalence of AIDs was 19.5% being AITDs (16.1%), the most frequently found. A higher prevalence of hypertension, dyslipidemia and overweight or obesity was found in patients who had exclusively AITDs. A higher prevalence of diabetic retinopathy (DR) was observed in patients with AITDs and patients with other AIDs in combination with AITDs. Chronic kidney disease (CKD) was more prevalent in patients with only AITDs. Lower levels of HbA1C, were observed in patients with isolated AITDs or with other AIDs, regardless of the presence of AITD. Hierarchical multivariate analysis, showed that AIDs were associated with female gender, older age, and longer diabetes duration, self-reported color-race (White and Brown), geographic region (Brazilian North/Northeast region) and higher anti-TPO levels (≥ 35 UI/ml). Conclusions In conclusion, Brazilian patients with T1D, belonging to a highly ethnically admixed population, had an important prevalence of AIDs, mostly AITDs, that was associated with female gender, self-reported color-race, older age and longer diabetes duration. Moreover, these patients also had a higher prevalence of DRCC. Even though we highlight the importance of investigating the presence of AIDs at diagnosis and at regular intervals, it is unclear whether screening and early detection of additional AIDs may improve the clinical outcomes in individuals with T1D. Future prospective studies are necessary to establish the interplay between T1D, AIDs and DRCC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of autoimmune diseases in an admixed population of patients with type 1 diabetes: a multicenter study in Brazil

Gomes,

Braga,

Drummond

et al. 2024

Diabetol Metab Syndr

View full text Add to dashboard Cite

show abstract

“…However, although T1DM is an organ-specific autoimmune disorder, individuals with T1DM often exhibit a higher risk of additional autoimmune disorders[ 5 ]. The concomitant presentation of T1DM and another autoimmune disorder may complicate diabetes management and result in varying clinical symptoms, thus seriously influencing patient quality of life[ 6 ]. Among these additional autoimmune disorders co-occurring among children and adolescents with T1DM, autoimmune thyroid disease (AITD) accounts for the highest proportion[ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Association of autoimmune thyroid disease with type 1 diabetes mellitus and its ultrasonic diagnosis and management

Wang,

Wan,

Chang

et al. 2024

World J Diabetes

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As a common hyperglycemic disease, type 1 diabetes mellitus (T1DM) is a complicated disorder that requires a lifelong insulin supply due to the immune-mediated destruction of pancreatic β cells. Although it is an organ-specific autoimmune disorder, T1DM is often associated with multiple other autoimmune disorders. The most prevalent concomitant autoimmune disorder occurring in T1DM is autoimmune thyroid disease (AITD), which mainly exhibits two extremes of phenotypes: hyperthyroidism [Graves' disease (GD)] and hypo-thyroidism [Hashimoto's thyroiditis, (HT)]. However, the presence of comorbid AITD may negatively affect metabolic management in T1DM patients and thereby may increase the risk for potential diabetes-related complications. Thus, routine screening of thyroid function has been recommended when T1DM is diagnosed. Here, first, we summarize current knowledge regarding the etiology and pathogenesis mechanisms of both diseases. Subsequently, an updated review of the association between T1DM and AITD is offered. Finally, we provide a relatively detailed review focusing on the application of thyroid ultrasonography in diagnosing and managing HT and GD, suggesting its critical role in the timely and accurate diagnosis of AITD in T1DM.

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Autoimmune diseases and the risk and prognosis of latent autoimmune diabetes in adults

Santoso,

Wei,

Ahlqvist

et al. 2024

Diabetologia

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Aims/hypothesis The aim of this study was to clarify the impact of autoimmune disease (AD) comorbidity on the risk and prognosis of latent autoimmune diabetes in adults (LADA). Methods We used data from a Swedish study comprising newly diagnosed cases of LADA (n=586, stratified into LADAlow and LADAhigh by autoantibody levels), type 2 diabetes (n=2003) and matched control participants (n=2355). Information on 33 ADs and diabetic retinopathy was obtained by linkage to regional and national registers. We estimated the ORs for LADA and type 2 diabetes in relation to ADs before diabetes diagnosis, and the HRs for diabetic retinopathy after diabetes diagnosis. We performed functional pathway analyses to explore biological mechanisms driving the associations. Results Individuals with ADs exhibit an increased susceptibility to LADA (OR 1.70; 95% CI 1.36, 2.13), particularly those with thyroid dysfunction (OR 1.88; 95% CI 1.38, 2.56), inflammatory bowel disease (OR 1.78; 95% CI 1.00, 3.16) or vitiligo (OR 3.91; 95% CI 1.93, 7.94), with stronger associations being observed for the LADAhigh phenotype. Only psoriasis was linked to type 2 diabetes (OR 1.47; 95% CI 1.08, 1.99). The biological pathways shared by LADA and ADs revolved around immune responses, including innate and adaptive immune pathways. The HRs for diabetic retinopathy in LADA patients with and without AD vs those with type 2 diabetes were 2.11 (95% CI 1.34, 3.32) and 1.68 (95% CI 1.15, 2.45), respectively. Conclusions/interpretation We confirm that several common ADs confer an excess risk of LADA, especially LADA with higher GADA levels, but having such a comorbidity does not appear to affect the risk of diabetic retinopathy. Graphical Abstract

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Comorbid autoimmune diseases and burden of diabetes-related complications in patients with type 1 diabetes from a Mediterranean area

Cited by 5 publications

References 39 publications

Prevalence of autoimmune diseases in an admixed population of patients with type 1 diabetes: a multicenter study in Brazil

Prevalence of autoimmune diseases in an admixed population of patients with type 1 diabetes: a multicenter study in Brazil

Association of autoimmune thyroid disease with type 1 diabetes mellitus and its ultrasonic diagnosis and management

Autoimmune diseases and the risk and prognosis of latent autoimmune diabetes in adults

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